Journal of cardiovascular and thoracic research
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J Cardiovasc Thorac Res · Jan 2012
An Evaluation of the Effect of Morphine on Abdominal Pain and PeritonealIrritation Signs in Patients with Acute Surgical Abdomen.
Acute surgical abdomen is one of the most common emergency surgical causes all over the world and also one of the most important abdominal pain causes which is sometimes intolerable for the patients referring to the emergency departments. Diagnosis and planning for operation in these cases is based on time-demanding serial examinations and results of paraclinical data. In this waiting period, patients have to tolerate pain.Therefore, we aimed to study the hypothesis that relieving pain has no influence on valuable findings in physical examination. ⋯ Despite the fact that opioid analgesics decrease pain in patients with acute surgical abdomen, they do not tend to eliminate required diagnostic data being obtained from physical examination like tenderness and rebound tenderness. Surprisingly, all the acute abdomen cases had rebound tenderness after morphine administration. Therefore, this research advises a cautious usage of morphine in patients with acute abdomen.
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J Cardiovasc Thorac Res · Jan 2012
Serum Cortisol Levels as a Predictor of Neurologic Survival inSuccessfully Resuscitated Victims of Cardiopulmonary Arrest.
Out-of-hospital cardiac arrest (OHCA) is the most stressful lifetime event for the victims and an important issue for the emergency physicians. The status of the hypothalamic pituitary- adrenal axis (HPA) function in successfully resuscitated victims of cardiopulmonary arrest has been recently of an interest for the researchers. ⋯ serum cortisol levels after 5 minutes and one hour of ROSC in victims of cardiopulmonary arrest are significantly higher in neurologically survived than non-survived patients.
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Unsuccessful tracheal intubation is considered the most common cause of anesthesia death or brain damage. This study delineates our experience recommending modifications in the cricothyroidotomy technique. ⋯ Several studies using cadavers and human simulators have demonstrated the pre-hospital feasibility of this technique. However, descriptions of clinical pre-hospital experience with percutaneous cricothyroidotomy are limited. This study shows that skill lab may help residents to acquire techniques required in management of difficult airway.
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J Cardiovasc Thorac Res · Jan 2012
Administration of Remifentanil in Establishing a more Stable Post-anesthesia Cardiovascular Status in Neurosurgical Procedures.
Emergence from general anesthesia and especially post-extubation phase are the stages associated with cardiovascular hyperdynamic status in which patients with increased intracranial pressure (ICP) could be affected by severe cardiac and or cerebral complications. Administering remifentanil could be helpful in maintaining the hemodynamic stability at the end of the surgery and recovery stages and reducing recovery phase length. ⋯ Remifentanil could be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length. However, administration of this medication should be performed cautiously.